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Transplantation . SARS-CoV-2-Specific Cell-Mediated Immunity in Kidney Transplant Recipients Recovered from COVID-19

tetano

Editor, Senior Moderator
Transplantation


. 2021 Feb 8.
doi: 10.1097/TP.0000000000003672. Online ahead of print.
SARS-CoV-2-Specific Cell-Mediated Immunity in Kidney Transplant Recipients Recovered from COVID-19


Mario Fern?ndez-Ruiz[SUP] 1 [/SUP], Beatriz Olea, Estela Gim?nez, Roc?o Laguna-Goya, Hernando Trujillo, Fernando Caravaca-Font?n, Eduardo Guti?rrez, Francisco L?pez-Medrano, Mar?a Jos? Remigia, Patricia Almendro-Vazquez, Natalia Polanco, Esther Gonz?lez, Tamara Ruiz-Merlo, Patricia Parra, Rafael San Juan, Amado Andr?s, David Navarro, Jos? Mar?a Aguado



Affiliations

Abstract

Background: The magnitude and kinetics of severe acute respiratory syndrome coronavirus 2-specific cell-mediated immunity (SARS-CoV-2-CMI) in kidney transplant (KT) recipients remain largely unknown.
Methods: We enumerated SARS-CoV-2-specific interferon-?-producing CD69 CD4 and CD8 T-cells at months 4 and 6 from the diagnosis of coronavirus disease 2019 (COVID-19) in 21 KT recipients by intracellular cytokine staining. Overlapping peptides encompassing the SARS-CoV-2 spike (S) glycoprotein N-terminal 1- to 643-amino acid sequence and the membrane protein were used as stimulus. SARS-CoV-2 IgG antibodies targeting the S1 protein were assessed by ELISA at month 6.
Results: Detectable (?0.1%) SARS-CoV-2-specific CD4 T-cell response was found in 57.1% and 47.4% of patients at months 4 and 6. Corresponding rates for CD8 T-cells were 19.0% and 42.1%, respectively. Absolute SARS-CoV-2-specific T-cell counts increased from month 4 to month 6 in CD8 (P-value = 0.086) but not CD4 subsets (P-value = 0.349). Four out of 10 patients with any detectable response at month 4 had lost SARS-CoV-2-CMI by month 6, whereas 5 out of 9 patients mounted SARS-CoV-2-CMI within this period. All but two patients (89.5%) tested positive for SARS-CoV-2 IgG. Patients lacking detectable SARS-CoV-2-specific CD4 response by month 6 were more likely to be under tacrolimus (100.0% versus 66.7%; P-value = 0.087) and to have received tocilizumab for the previous COVID-19 episode (40.0% versus 0.0%; P-value = 0.087).
Conclusions: Although still exploratory and limited by small sample size, the present study suggests that a substantial proportion of KT recipients exhibited detectable SARS-CoV-2-CMI after 6 months from COVID-19 diagnosis.
 
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